COVID-19 and Sex-/Gender-Specific Differences: Understanding the Discrimination

Amgalan, Ariunzaya; Malinowski, Ann Kinga; Othman, Maha

doi:10.1055/s-0040-1715455

Cited by 13 publications

(11 citation statements)

References 73 publications

(98 reference statements)

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“…The reasons for sex-associated differences in COVID-19 are still unclear. Sex-based biological differences, which affect cell-mediated immunity and antibody production as well as gender-based behavioral differences such as smoking and handwashing are discussed [ 17 ]. We also analyzed sex-specific differences in our patient cohort but found no statistically significant association between sex and outcome.…”

Section: Discussionmentioning

confidence: 99%

Age Related Differences in Monocyte Subsets and Cytokine Pattern during Acute COVID-19—A Prospective Observational Longitudinal Study

Pirabe

Heber

Schrottmaier

et al. 2021

Cells

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The COVID-19 pandemic drastically highlighted the vulnerability of the elderly population towards viral and other infectious threats, illustrating that aging is accompanied by dysregulated immune responses currently summarized in terms like inflammaging and immunoparalysis. To gain a better understanding on the underlying mechanisms of the age-associated risk of adverse outcome in individuals experiencing a SARS-CoV-2 infection, we analyzed the impact of age on circulating monocyte phenotypes, activation markers and inflammatory cytokines including interleukin 6 (IL-6), IL-8 and tumor necrosis factor (TNF) in the context of COVID-19 disease progression and outcome in 110 patients. Our data indicate no age-associated differences in peripheral monocyte counts or subset composition. However, age and outcome are associated with differences in monocyte activation status. Moreover, a distinct cytokine pattern of IL-6, IL-8 and TNF in elderly survivors versus non-survivors, which consolidates over the time of hospitalization, suggests that older patients with adverse outcomes experience an inappropriate immune response, reminiscent of an inflammaging driven immunoparalysis. Our study underscores the value, necessity and importance of longitudinal monitoring in elderly COVID-19 patients, as dynamic changes after symptom onset can be observed, which allow for a differentiated insight into confounding factors that impact the complex pathogenesis following an infection with SARS-CoV-2.

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Section: Discussionmentioning

confidence: 99%

Age Related Differences in Monocyte Subsets and Cytokine Pattern during Acute COVID-19—A Prospective Observational Longitudinal Study

Pirabe

Heber

Schrottmaier

et al. 2021

Cells

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“…[In addition to the biological factors that differentiate women and men, there are behavioural and lifestyle factors that can influence the development of COVID-19 disease. These differences are shown in Figure 1 [13]. [14].…”

Section: Why Do Women Have Less Severe Covid-19 Symptoms Than Men?mentioning

confidence: 87%

Combined hormonal contraception and COVID-19

Lete

2021

The European Journal of Contraception & Reproductive Health

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Aim: This article reviews the possibility of using combined hormonal contraception during the COVID-19 pandemic. Methods: narrative review Results: The factors that protect women from the severity of the disease are analysed, as well as the risk factors for the use of this type of contraception, especially related to the increased risk of a thrombotic event in patients affected by the disease. Finally, the information available on the guidelines for action in patients with COVID-19 using combined hormonal contraception is collected. Conclusions: We can continue to prescribe and use hormonal methods with EE.

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“…On the other hand, comorbidities have been reported as important clinical predictors in COVID-19 infection, and a sexually dimorphic phenotypic expression of the main underlying disease, such as coronary artery disease, 47 could possibly have a role in explaining the different outcomes between genders. 46,48 Aside from biolog-ical factors, gender-based behavioral and lifestyle differences may contribute to the male predisposition for more severe disease. Smoking is a well-known predisposition factor for cardiopulmonary comorbidities through alteration of the renin-angiotensin-aldosterone system homeostasis.…”

Section: Discussionmentioning

confidence: 99%

“…Smoking is a well-known predisposition factor for cardiopulmonary comorbidities through alteration of the renin-angiotensin-aldosterone system homeostasis. 46 Based on clinical evaluation, therapeutic options available for SMH are supportive care and blood transfusion alone, embolization procedures and surgical procedures. 49 In the systematic review including our patients,17 COVID-19 patients with SMH were identified for radiological treatment without influencing prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…This can be framed in the contest of a more severe clinical expressiveness of COVID-19 in males observed in China and in other Countries, such as Italy. 46 This difference may be due both to hormonal differences and comorbidities. In males, the androgen receptor activates the transcription of a transmembrane protease serine 2, the activity of which appears key to SARS-CoV-2 virus spread and aggressiveness in the infected hosts, through the priming of viral spike protein.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Muscle Hematoma in Patients with COVID-19: A Systematic Literature Review with Description of an Additional Case Series

Abate

Casoria

Rendina

et al. 2021

Semin Thromb Hemost

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Coagulation abnormalities, thrombosis, and endothelial dysfunction have been described in COVID-19 patients. Spontaneous muscle hematoma (SMH) is a rare complication in COVID-19. The aims of this study are to: (1) perform a systematic review of the literature to better define the clinical SMH characteristics, (2) describe the prevalence and the clinical characteristics of SMH in COVID-19 patients referring to a Department of Internal Medicine (IM) (Federico II University of Naples), a Department of Sub-Intensive Care Medicine (SIM) (Ospedale Del Mare), and a Department of Intensive Care Unit (ICU) (Federico II University). The systematic review was performed according to PRISMA criteria. The local prevalence of SMH in COVID-19 was evaluated retrospectively. The medical records of all COVID-19 patients referring to IM and ICU from March 11th, 2020, to February 28th, 2021 were examined for SMH occurrence. In our retrospective analysis, we describe 10 cases of COVID-19 patients with SMH not previously reported in literature, with a prevalence of 2.1%. The literature review, inclusive of our case series, describes a total of 50 SMHs in COVID-19 patients (57.4% males; mean age 68.8 ± 10.0 years). The SMH sites were ileo-psoas, vastus intermedius, gluteus, sternocleidomastoid, and pectoralis major muscles. Males developed SMH earlier than females (9.5 ± 7.8 vs. 17.1 ± 9.7 days). Ileo-psoas hematoma was more frequent in males (69.2 vs. 30.8%), while pectoralis major hematoma occurred only in females. The in-hospital mortality rate of SMH in COVID-19 patients was 32.4%. SMH is a rare but severe complication in COVID-19 hospitalized patients, associated with high mortality. A gender difference seems to be present in the clinical presentation of the disorder.

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COVID-19 and Sex-/Gender-Specific Differences: Understanding the Discrimination

Abstract: This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 13 publications

References 73 publications

Age Related Differences in Monocyte Subsets and Cytokine Pattern during Acute COVID-19—A Prospective Observational Longitudinal Study

Age Related Differences in Monocyte Subsets and Cytokine Pattern during Acute COVID-19—A Prospective Observational Longitudinal Study

Combined hormonal contraception and COVID-19

Spontaneous Muscle Hematoma in Patients with COVID-19: A Systematic Literature Review with Description of an Additional Case Series

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